摘要
目的探讨本院新生儿重症监护病房中新生儿呼吸衰竭（neonatalrespiratorvfailure，NRF）的发生及治疗情况。方法对2008年1月1日至12月31日问本院NICU诊断的626例NRF患儿进行回顾性资料收集及统计分析，了解NRF的发生、救治状况、病死高危因素及疾病负担，并采用卡方检验与其他研究结果进行比较。结果在连续12个月间，NRF患儿626例，占本院同期新生儿重症监护病房收治患儿的38．9％（626／1608），总的院内病死率为22．5％（141／626），其中放弃治疗的比例占95．0％（134／141），病死率较2004年至2005年（37．2％，113／304）有所下降，且低于同期全国性研究（24．7％，1683／6864）。肺炎／败血症（34．8％，218／626）、新生儿呼吸窘迫综合征（31．6％，198／626）、胎粪吸入综合征（10．7％，67／626）等是NRF的首要原发疾病，肺炎／败血症（5．4Yoo，34／626）、颅内出血（4．6％，29／626）、持续性肺动脉高压（3．2％，20／626）等是主要院内并发症。本院NRF患儿的肺表面活性物质应用率显著提高，由2004年至2005年的14．1％（43／304）上升至23．6％（149／626），接近国内平均水平（26．8％，1840／6864）。70．2％（139／198）的新生儿呼吸窘迫综合征患儿接受了肺表面活性物质治疗，12．1Yoo（24／198）应用了气管插管-肺表面活性物质-拔管使用持续气道正压通气技术。2．7％（17／626）的患儿接受了一氧化氮吸人治疗。经鼻持续气道正压通气使用率由2004年至2005年的47．1％（143／304）上升至76．5％（479／626），常频通气由72．7％（221／304）下降至49．8％（312／626），高频通气由0．7％（2／304）上升至10．5Yoo（66／626），各种辅助通气构成变化与全国性研究结果一致。治愈和好转出院的480例患儿中，住院总天数平均为（15．1±4．0）d，住院总费用为（127524-5148）元
Objective To investigate the incidence, treatment and prognosis of neonatal respiratory failure （NRF） in the Neonatal Intensive Care Unit of Children＇s Hospital of Hebei Province. Methods The medical data of 626 NRF newborns admitted to the Neonatal Intensive Care Unit of Children＇s Hospital of Hebei Province from January 1st, 2008 to December 31st, 2008 were collected, and the pathogenesis of NRF, management, risk factors of their deaths and cost for the disease were studied. The results were compared with the national study in the same period and the local study of 2004 2005 by Chi-square test. Results During the 12 consecutive months, the incidence of NRF in neonatal intensive care unit was 38.9% （626/1608）. The mortality in hospital was 22.5% （141/626）, among which, most deaths （134, 95.0%） occured after early discharge required by the parents. The mortality decreased by 14.7% compared with that during 2004-2005 （37.2%, 113/304）, and was also lower than that （24.7%,1683/6864） in the national study at the same period. Pneumonia/sepsis （34. 8%, 218/626）, neonatal respiratory distress syndrome （31.6%,198/626）, and meconium aspiration syndrome （10.7G ,67/626） were leading primary causes of NRF. The majorcomplications were pneumonia/sepsis （5.4%% ,34/626）, intracranial hemorrhage （4.6% ,29/626） and persistent pulmonary hypertension （3.2%, 20/626 ）. The percentage of NRF babies requiring pulmonary surfactant rose from 14.1% （43/304） during 2004-2005 to 23.6% （149/626） in 2008, which almost reached the national level of 26.8% （1840/6864）. Pulmonary surfactant treatment was accepted by 70.2% （139/198） patients with neonatal respiratory distress syndrome. 12.1% （24/198） of neonatal respiratory distress syndrome infant was administered immediate intubation-surfactantextubation. Seventeen （2.7%） patients accepted nitric oxygen treatment. Nasal continuous positive airway pressure was given to 76.5%（479/626） patients, which was higher than bef
出处
《中华围产医学杂志》
CAS
北大核心
2012年第11期670-675,共6页
Chinese Journal of Perinatal Medicine
关键词
呼吸功能不全
发病率
婴儿
新生
流行病学
Respiratory insufficiency
Incidence
Infant, newborn Epidemiology
